Scintigraphic Evaluation of Osseointegrative Response around Calcium Phosphate-Coated Titanium Implants in Tibia Bone: Effect of Platelet-Rich Plasma on Bone Healing in Dogs

Abstract

Differential diagnoses for canine bone disease are commonly based on radiography. However, scintigraphy is a nuclear scanning test to trace bone healing during stress fracture and osteomyelitis and thus can be used to probe the osseointegration process in vivo in the context of the dental implant. The purpose of this study was to explore the possibility of using noninvasive scintigraphy to probe the effect of platelet-rich plasma (PRP) to enhance osseointegration of the implant and to confirm the result with a parallel histological examination in adult beagle dogs. Two independent calcium phosphate-coated titanium screw implants 8 mm in length and 4 mm in diameter were inserted into each tibia in 4 dogs (4 implants/animal, total = 16). The PRP-treated group was deposited with 0.5 ml of PRP into the drill hole in the right tibia; the control group was instilled with 0.5 ml of saline into the drill hole in the left counterpart before titanium screw implantation. Radiography of the implanted tibias showed complete osseointegration but no osteomyelitis. No difference in the ossification of the peri-implant bone on the radiographs was observed between the two groups during the experimental period. However, the scintigraphic findings revealed obvious differences in bone uptake between the two groups. The higher bone uptake in the PRP-treated group significantly increased bone activity and faster bone regeneration compared to the control group (p < 0.05) at 4 weeks after implantation. The percentage of the bone-to-implant contact on histological examination in the PRP-treated group showed dense cortical bone formation in close contact with the metallic surface of the titanium implant (p < 0.05). Quantitative histological analysis correlated well with that of the scintigraphic evaluation as revealed by Pearson correlation analysis (r = 0.72, p < 0.05). Thus, scintigraphy is a sensitive and noninvasive method suitable for osseointegration of the implant in vivo.

Platelet-Rich Plasma in the Animal Long-Bone Model: An Analysis of Basic Science Evidence

“…5, Twenty-one (72%) of the 29 studies reported either platelet concentrations or percentage increase of platelet concentration (Table 1). 5,13,14,16,17,[20][21][22][23][24][25]27,29,[31][32][33][34][35][36][37][38] All showed that platelet levels were significantly higher than whole blood. One (3%) study reported CD4+ and CD8+ levels for PRP, 38 and 1 (3%) study reported leukocyte and fibrinogen counts.…”

“…18,22,23,32,38 Four (14%) studies used a rat model, 3 of which investigated the femur 5,15,35 and 1 of which investigated the tibia. 37 Four (14%) studies used a canine model, investigating 1 femur, 19 1 tibia, 13 1 radius, 36 and 1 ulna. 33 Four (14%) studies used a sheep model: 2 investigated the tibia, 31,34 1 investigated the femur, 17 and 1 investigated both the femur and the tibia.…”

“…Sixteen (89%) of the 18 studies showed statistically significant improvements in either earlier bone healing, higher tissue differentiation rates, or higher rates of bone regeneration. [13][14][15][16][20][21][22][23][24][25][26][27]30,32,37,38 Of the 11 studies that did not report statistics, 9 (82%) showed qualitative improved bone healing. 5,11,18,19,28,29,31,35,36 Of the 29 studies, 15 (52%) performed a radiologic assessment of the treated and control bone defects.…”

“…5, Only 18 (62%) of these studies reported full quantitative results with all means and SDs. [12][13][14][15][16][17][20][21][22][23][24][25][26][27]30,32,37,38 The other 11 (38%) reported their results as descriptions, graphs, selectively reported means, or means without SDs. For radiographs, 6 (40%) of 15 studies performed a form of numerically based analysis.…”

Effect of platelet‐rich plasma on peri‐implant trabecular bone volume and architecture: A preclinical micro‐CT study in beagle dogs

“…Platelet‐rich plasma therapy has been found in varied surgical fields to be able to enhance bone and soft tissue healing by placing autologous platelets at supra‐physiological concentrations (Dhillon, Schwarz, & Maloney, ). For instance, increased bone activity and faster bone regeneration after using PRP were revealed by scintigraphy in dogs (Cho et al, ). In spite of a recent controversial finding reporting that PRP combined with bovine‐derived xenograft may delay peri‐implant bone healing in rabbits (Peng et al, ), there are also some in vitro animal experiments and preliminary clinical trials, which indicate that peri‐implant sensory feedback may be modified and promoted by various growth factors released from autologous PRP (Huang et al, ).…”